Cooperative Health Center Inc.Helena, Montana

Patrick Frawley, LCSW

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Our Community

Lewis & Clark County covers 3,500 square miles

2009 estimated population of 62,000 Average per capita income $19,000 29% below 200% poverty level, and 44% of

those are uninsured

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Our Clinic

Opened in 1994 Satellite clinics – Lincoln, MT and God’s Love Shelter Primary Health & Dental Care, Mental Health, Case

Management & Medication Assistance Program 6 Medical Providers, 1 Mental Health Provider, 1 Case

Manager, 1 Diabetes Educator Typically serve 6000 individuals per year 20,000 encounters per year EMR implemented in May 2009 Telemedicine by end of 2010

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President’s New Freedom Commission on Mental Health

Commission was created in April 2002

Report submitted to President July 2003

www.mentalhealthcommission.gov/reports/reports

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In a Transformed Mental Health System...

Goal 1 – Americans Understand that Mental Health is Essential to Overall Health.

Goal 2 – Mental Health Care is Consumer and Family Driven.

Goal 3 – Disparities in Mental Health Services are Eliminated.

Goal 4 – Early Mental Health Screening, Assessment, & Referral to Services are Common

Practice. Goal 5 – Excellent Mental Health Care is Delivered and

Research is Accelerated. Goal 6 – Technology is Used to Access Mental Health

Care and Information.

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Goal 4.4: Screen for Mental Disorders in Primary Care, across the lifespan and connect to treatment and supports.

This is where we fit in Why was this Important to us?

70% of our patient population carries a mental

health and/or chemical dependency diagnosis

Very high rate of suicide in our community

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Our Vision

Integrate Mental Health & Chemical Dependency Services into Primary Health Care

Received ORHP Grant in 2006

Hired staff, and developed a Community Consortium. The goal of the consortium

was to increase patient access to psychiatric & CD services.

Boyd Andrew Community Services

Center for Mental Health

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How We Proceeded

Fulltime LCSW and Case Manager hired in 2006 LCSW provides brief, focused, cognitive behavioral

therapy on site Case Manager provides care coordination, resource &

referral services No wrong door – meet and greet Our services are provided on the medical hall Bridge to Boyd Andrew CS & Center for Mental Health

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Reality vs. Vision

The road to hell is paved with good intentions.

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Our Efforts Met with Limited Success:

We inherited a grant that promised the moon and stars

Assumed level of support from staff

Boyd Andrew & Center for Mental Health had inadequate organizational commitment and service capacities

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Data – Data – Data

The challenge to collect data

The challenge to demonstrate progress & outcomes

November, 2007 – Patient Tools implemented

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Some of Our Findings

2007 to present – 1100 screenings

Suicide ideation

Diagnostic Prevalence and Change (2008/2009)Major Depression 31% decreasePTSD 16% decreaseBipolar Disorder 30% decreaseGeneralized Anxiety Disorder 17% decreasePanic Disorder 35% decrease

Chemical Dependency 65% decrease

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Outcomes & Lessons Learned

Patients pleased with our services One stop shopping Services less stigmatized in medical setting Patients like progress reports Sustainability is complex…

lots of support but little funding

We almost lost our jobs…

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Received New ORHP Funding 2009!

This allowed us to continue and expand our Mental Health Program

We are now targeting CHC patients with co-morbid Diabetes & Mental Health Diagnoses to improve mental health and diabetes control.

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If you have further questions, please contact us:

Patrick Frawley, LCSWMental Health CoordinatorCooperative Health Center1930 9th Ave.Helena, MT 59601(406)457-8982pfrawley@co.lewis-clark.mt.us

Rebecca BarabyCase ManagerCooperative Health Center1930 9th Ave.Helena, MT 59601(406)457-8983rbaraby@co.lewis-clark.mt.us